Every city had shantytowns known as Hoovervilles during the Great Depression. The one below was located where Seattle’s Safeco Field is today. It’s probably no surprise to you that shantytowns are making a comeback lately. Also not surprising is that they’ve become a hot issue for cities and citizens, and for the homeless who are camped there and must pack up and move every few weeks. Literate, cosmopolitan Seattle hosts a 100-person tent city called Nickelsville, named for the mayor.

The demographics of homelessness have changed. Just five years ago, the homeless were mostly folks who even under the best circumstances have trouble with the basic structures of mainstream living. Many suffer from intractable mental illness or substance abuse problems. Not anymore. Now the homeless ranks include out-of-work electricians, engineers, and others who once worked for an hourly wage. Photo by MOHAI.

audrey young

I'm a general internist from Seattle. My first book was What Patients Taught Me. The latest book is House of Hope and Fear, published in August 2009, and now out in paperback. For more about both books and about physician writers, please visit my website.